- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Audit Readiness Specialist II Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los Angeles, CA, US, 90017 ... achieve that purpose. Job Summary The Customer Solution Center (CSC) Audit Readiness Specialist II is responsible for the execution, oversight, and monitoring of the… more
- Johns Hopkins University (Baltimore, MD)
- We are seeking a **_Coding Specialist II_** who will be responsible for all aspects of coding, quality assurance, compliance with Federal payer documentation ... Responsibilities** + Responsible for all aspects of coding, quality assurance and compliance with Federal payer documentation guidelines. + Works closely with Office… more
- Elevance Health (AL)
- …prevent unnecessary medical-expense spending. **Title** : Financial Operations Recovery Specialist II **Location:** This role enables associates to work virtually ... is granted as required by law. The **Financial Operations Recovery Specialist II** is responsible for the discovery, validation, recovery, and adjustments… more
- DiPasquale Moore (Kansas City, MO)
- Health Insurance Lien Specialist / Administrative Assistant Kansas City, Missouri Competitive salary commensurate with experience! REQUIREMENTS: High School Diploma ... Job Overview: We are seeking a Health Insurance Lien Specialist to join our personal injury law firm. The...related to health insurance and their liens, including Medicaid, Medicare , and ERISA. This role is crucial in ensuring… more
- HCA Healthcare (Marion, NC)
- …hours volunteering in our communities. As a Life Safety and Environment of Care Specialist on our Facilities Services team with Mission Hospital McDowell you can be ... organization. We are looking for an enthusiastic Life Safety and Environment of Care Specialist to help us reach our goals. Unlock your potential! **Job Summary and… more
- New York State Civil Service (New York, NY)
- …office leadership to coordinate training efforts to ensure employees remain in compliance with regulatory requirements. The Training Specialist 2 will also ... NY HELP Yes Agency People With Developmental Disabilities, Office for Title Training Specialist 2 Mental Hygiene - (Talent Development & Training Dept) - EOA… more
- Centers for Medicare & Medicaid Services (Woodlawn, MD)
- … Specialist , GS-13, you will develop, evaluate, and implement compliance , audit, and oversight requirements, policies, and operating procedures related to ... Department of Health & Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), Center for Medicare... Medicare & Medicaid Services (CMS), Center for Medicare and Medicaid Innovation, Seamless Care Models Group, Division… more
- Insight Global (Nashville, TN)
- Job Description . Specialist performs pre- and post-payment audits of external claims; ensures that the company rigorously manages claims for external services; ... India. . Assisting with end-to-end claims process, ensuring accuracy, timeliness, and compliance . . Assist with Processing & Review on complex claims, including… more
- PruittHealth (Norcross, GA)
- …for health plans * Knowledge of CMS required contracting language for Medicare Advantage Plan agreements * Demonstrate compliance with CMS regulations ... **JOB PURPOSE:** The purpose of the Provider Relations Development Specialist role for PruittHealth Premier to support the plans...them effectively to providers and teammates. * Complete annual Medicare Fraud, Waste and Abuse Training and Model of… more
- Beth Israel Lahey Health (Burlington, MA)
- …Coverage Determinations (LCD's), or Local Medical Review Policies (LMRP's) to ensure compliance with coding guidelines. 2. Stays current on quarterly CCI Edits, ... bi-monthly Medicare Bulletins, Medicare 's yearly fee schedule, ...Coder - Apprentice through AAPC), or CCS-P (Certified Coding Specialist Physician Based through AHIMA) Experience: 1-2 years of… more